Individual provider Active NPI

Dakota Ryan Eble

  • Family Medicine Physician
  • Chillicothe, OH
National Provider Identifier
1972354702
Registry record updated Mar 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
58.033921 Issued in OH
Practice address
4461 State Route 159 Ste a
Chillicothe, OH 45601-6000
Phone
(740) 779-4900
Fax
(740) 779-4909
NPI assigned
Mar 29, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 58.033921 OH Primary

Addresses

Primary practice location

4461 State Route 159 Ste a
Chillicothe, OH 45601-6000

Mailing address

4461 State Route 159 Ste a
Chillicothe, OH 45601-6000
Phone (740) 779-4900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250220000520 OH Order and Referring Only - Family PracticePractitioner - Family Practice 8426578568

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
58.033921OHMDFamily Medicine Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1711670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711670400000",
    "number": "1972354702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4461 STATE ROUTE 159 STE A",
            "city": "CHILLICOTHE",
            "state": "OH",
            "postal_code": "456016000",
            "telephone_number": "740-779-4900",
            "fax_number": "740-779-4909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4461 STATE ROUTE 159 STE A",
            "city": "CHILLICOTHE",
            "state": "OH",
            "postal_code": "456016000",
            "telephone_number": "740-779-4900",
            "fax_number": "740-779-4909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EBLE",
        "first_name": "DAKOTA",
        "middle_name": "RYAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-03-29",
        "last_updated": "2024-03-29",
        "certification_date": "2024-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "58.033921",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chillicothe, OH

Sources for this page

Verify at the official NPI Registry.